No doubt doctors and nurses are overworked. It occurs to me that our culture may set the bar too low on when to intervene. Things seem to go wrong more often than we like to acknowledge.
Heck, just sleeping a few nights in a hospital, without any treatment, already exposes a human to unhealthy hospital food, infectious disease, and a small, but non-zero, risk of a nurse mistakenly pumping you full of insulin.
Another example of doctors advocating checklists.
http://www.newyorker.com/magazine/2007/12/10/the-checklist
I like the quote from the doctor doing a lot of the work with checklists, answering a question about when they will be widely adopted in medicine:
“At the current rate, it will never happen,” [Pronovost] said, as monitors beeped in the background. “The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is insuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine. That’s a mistake, a huge mistake. And from a taxpayer’s perspective it’s outrageous.”
http://www.who.int/patientsafety/safesurgery/tools_resources...
Here's one article about it: https://news.ycombinator.com/item?id=436575
I was fortunate enough to earn my wings before becoming a developer, and as lame as it sounds, learning when and where to use checklists is one of the best lessons I learned.
If someone is getting a procedure, it seems like they should automatically be prescribed required medication unless they have been flagged with an adverse reaction. Sure, review this stuff, but the default needs to be less harmful than the supervised action.
I am guessing there are a lot of historical and cultural reasons why this does not happen. But, why can't we apply basic automation.
Until you get something fully automated, you have an extra person to understand/review decisions.
He told me his group of physicians had refused to treat anyone until the IT department removed the requirements for login to basic systems because they were sick of not being able to use their tools because a login didn't work for whatever reason - forgotten password, login system not working, it was all the same to them, they just wanted to be able to access their tools.
That was in Adelaide, South Australia, about 4 years ago.
If a hospital is run like a start up, the possibilities are rather mind boggling.
A startup is an experiment, most of them fail. It will probably also have an oversize share of people who don't mind risk but do like (monetary) profits, very much so. This means they will take risks with patients health and lives that we have already chosen not to accept except in cases where bad outcomes don't matter (patient is dying).
The "politics" can also be a lot worse in a fast-growth company with a lot of success-driven people. The risk of losing out is a lot lower in a "boring" company where everybody just gets their salary and advancement is slow and predictable. This leads to less focus on the product/service, because people are occupied with "positioning themselves".
There will also be investors, and they don't really care about the product at all, or about long-term success - as long as they can unload their shares at an IPO like the hot potatoes they often are they are fine. Which is not so because people are evil, but because the selection function is set up in a way that favors this behavior.
In a sense though you are right, the possibilities are rather mind boggling indeed. I just don't think in a positive way.
"He's got a cold -- let's just kill him"
"Startup hospital offers artisan cardiac catheterization"
I think that's a great idea.
I don't think it needs to be a start-up, but maybe the AMA, FDA, or whomever could put together a simple list of medical preventable errors, and publish that list in a easy to read format.
Just put the information out there. After my bypass; that will be the first book, or website I'm looking for.
Someting like, "After the first heart attack, an aspirin might prevent the second heart attack."
Something that would legally protect the Doctor.
It seems like the entire system is so afraid of lawsuits they just give the bare minimum of advice. And then there're the doctors who just don't really care.
Take adverse drug interactions as an example. The training data for drug interactions mostly come from adults, so the resulting models do not apply in a pediatric setting. When the models are let loose in pediatric hospital, a high percentage of the drug interaction warnings are false positives, so these type of warnings tend to be ignored.
It seems that the trend is to use decision support with a lot of human oversight and investigation of the raw data to see if the model conclusions are correct.
Ensuring blood thinners are prescribed post coronary bypass surgery or stenting is another one. It should happen every time, but sometimes by human error it may not.
A good startup idea would be to make a hotlist of the top ~1000 of these obvious, preventable errors, combine IT data sources to predict when they might be occuring, and have checking systems in place to prevent them. If it worked even adequately, hospitals would be seen as negligent for not using such a system.